Tics

Tics are surprisingly common, occurring in up to 24% of first and second graders. Tics are repetitive, rapid involuntary movements or vocalizations that are usually fairly easy to distinguish from other types of movement disorders. The most common tics are eye blinking, neck twisting, shoulder shrugging, grimacing, coughing, throat clearing and sniffing. The onset of tics is most common around 6-7 years of age. There is usually no obvious trigger. Most tics are mild and transient, resolving within a few weeks. Sometimes one tic will disappear only to be replaced by another. Tics are often initially mistaken for allergic symptoms, vision problems, or respiratory illnesses.

Sometimes tics can become more chronic. Chronic tics often peak between 10 and 12 years of age and usually resolve by the late teenage years. Tourette syndrome is a more severe form of tic with a combination of involuntary movements and vocalizations. Most tics, however, are fleeting and minor.

Children are often unaware of their tics, but they sometimes may be aware of an urge to perform the tic before it occurs. It may be possible, with considerable effort, to suppress the tic, but only temporarily. Anxiety, stress and excitement may all aggravate tics. It is important to make sure that children with tics do not suffer criticism, teasing or bullying, which will only make the tics worse.
Medications are only rarely indicated, and only for tics that are unusually severe, persistent, and disabling. For most tics, the possible side effects of effective medications outweigh the benefits. The most important response to tics is to be accepting of the child and the tic. It may also be helpful to watch for possible stresses that aggravate the tic and to work together with the child to try to reduce stresses when possible.